Healthcare Provider Details

I. General information

NPI: 1326933607
Provider Name (Legal Business Name): NEW MEXICO COUNSELING & TRAUMA RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10419 CALLE ACANTA NW
ALBUQUERQUE NM
87114-5233
US

IV. Provider business mailing address

10419 CALLE ACANTA NW
ALBUQUERQUE NM
87114-5233
US

V. Phone/Fax

Practice location:
  • Phone: 505-321-6009
  • Fax:
Mailing address:
  • Phone: 505-321-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HARRISON-SANCHEZ
Title or Position: OWNER/OPERATOR
Credential: LCSW
Phone: 505-321-6009